2023 Annual Chapter Financial Report

2023 Annual Chapter Financial Report

Short Form (For Chapters with 3-year Average Annual Gross Receipts of $50,000 or less) January 1 through December 31, 2023
Chapter Information
Name of person completing this form

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Select your chapter
Chapter Chair's Name (First and Last Name) and email address
If it is the same as the person submitting the form, enter SAME.
Chapter Treasurer's Name (First and Last Name) and email address
If it is the same as the person submitting the form, enter SAME.
Chair or Treasurer's Mailing Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

IRS Federal Form 990-N Chapter Filing Requirement
Check only one box

SME files 990-N. I authorize the Society of Manufacturing Engineers headquarters to file our chapter's Federal Form 990-N on our behalf and I acknowledge that it is ultimately the chapter officer's responsibility to file the chapter's information return. As an officer of this Society of Manufacturing Engineers (SME) chapter, I warrant that this Chapter's three-year average gross receipts, (including the gross receipts of any subordinate student chapter) are $50,000 or less, which entitles us to file the simpler Federal Form 990-N. I authorize SME, the parent organization, to file the Federal Form 990-N on our behalf, based on the information provided herein.Our chapter will file its own Federal Form 990-N. As an officer of this Society of Manufacturing Engineers chapter (SME), I warrant this Chapter's three year average annual gross receipts (including the gross receipts of any subordinate student chapter) are $50,000 or less, which entitles us to file the simpler Federal Form 990-N and I acknowledge I will file the necessary Federal Form 990-N on behalf of this Chapter.

Information needed for 990-N form
Has your chapter terminated or gone out of business?
If yes, please indicate date terminated.

MonthDayYear
2 digit month, 2 digit day, 4 digit yearContact Heather Palermo at hpalermo@sme.org to confirm chapter termination.
Chapter Tax ID Number
Professional Chapters Only
If your chapter conducts business using another name (dba), enter the other name:

Chapter Checking Account

Rows	AMOUNT$
Balance on 12/31/2022
+Total income from Income Schedule
-Total expense from Expense Schedule
+/- Transfers in/out
Balance on 12/31/2023

Chapter Savings Account

Rows	AMOUNT$
Balance on 12/31/2022
+Total income from Income Schedule
-Total expense from Expense Schedule
+/- Transfers in/out
Balance on 12/31/2023

Chapter Investments

Chapter Fixed Assets

Rows	AMOUNT$
Balance on 12/31/2022 from Asset Listing
+Assets purchased
-Assets disposed (at original cost)
Balance on 12/31/2023 from Asset Listing

Chapter Petty Cash

Other Assets

Income Schedule

Rows	AMOUNT$
Advertising Income
Contributions Received (Provide Detail Below)
Funding from Headquarters
Outings and Events Income
Meeting Income
Interest Income
Dividend Income
Other income -
Other income -
Other income -
Total

Expense Schedule

Rows	AMOUNT$
Accounting & Legal Expense
Scholarships & Awards Exp. (Provide Detail Below)
Donations Expense (Provide Detail Below)
Meeting Expense
Postage and Shipping Expense
Printing Expense
Supplies Expense
Travel Expense
Outings and Events Expense
Other Expense -
Other Expense -
Other Expense -
Total

Additional Detail Required for the Federal Tax Return (attach additional pages, as necessary)

Contributions Received (List individual contributions over $500)

Rows	Amount
Contribution
Contribution
Contribution
Total Contributions Received per Income Schedule

Scholarships & Awards Paid

Rows	Name & Address of Recipient	Amount
Scholarship
Scholarship
Scholarship
Total Scholarships & Awards per Expense Schedule

Donations Made

Rows	Name & Address of Recipient	Amount
Donation
Donation
Donation
Total Donations Made per Expense Schedule

Fixed Asset Listing

Rows	Date Acquired	Description & Who Has Possession	Amount
Asset
Asset
Asset
Total Fixed Assets per Account Reconciliation

Upload any additional financial information or spreadsheet. (This is not required)

Cancelof

Bank Information

Tell us how you would like any funds received
Send funds via
If check, please provide how you want the check made out and the address where it should be sent.
If ETF, please provide the following information
Account Type

Other
Bank Name
Account Number
Routing Number

Signature of person completing this form
By submitting this form, I am declaring under penalty of perjury that the authorization and the information provided is true and complete. I am aware that the Federal Form 990 or 990-N is due annually on May 15th and that the parent organization may not be able to file on our behalf, if the information is not received in a timely manner.
Should be Empty:

Chapter Information